WHO cites grand inequalities

1st September 2008

After a three-year study, the World Health Organisation (WHO) reports that inequalities within countries are "killing people on a grand scale."

"(The) toxic combination of bad policies, economics, and politics is, in large measure responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible," the WHO Commission on the Social Determinants of Health wrote.

"Social injustice is killing people on a grand scale," the panel wrote in "Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health," presented 28 August to WHO Director-General Margaret Chan.

Among inequities cited in the report:

Life expectancy for Indigenous Australian males is shorter by 17 years than all other Australian males.

Maternal mortality is three to four times higher among the poor compared to the rich in Indonesia. The difference in adult mortality between least and most deprived neighbourhoods in the United Kingdom is more than 2.5 times.

Child mortality in the slums of Nairobi is 2.5 times higher than in other parts of the city. A baby born to a Bolivian mother with no education has 10% chance of dying, while a baby born to a woman with at least secondary education has a 0.4% chance.

In the United States, 886,202 deaths would have been averted from1991-2000 if mortality rates between white and African Americans were equalised. By contrast, 176,633 lives were saved in the United States by medical advances in the same period.

In Uganda the death rate of children under five in the richest fifth of households is 106 per 1,000 live births, but in the poorest fifth of households in Uganda it is even worse - 192 deaths per 1,000 live births. This means that nearly one-fifth of all babies born alive to the poorest households will die before their fifth birthday. The average death rate for children under five in high-income countries is seven per 1,000.

In Russia, a 20-year-old male with a university education can expect to live an average of 52 years, more than a decade longer than his counterpart with a primary education, who will live on average to 40.

Average life expectancy is lowest across Africa, at 48 years. The highest average is in North America , where people can expect to live an average of 77 years. European life expectancy is 74; Latin America and Asia reach 71 and 67 years, respectively.

The nadir is Sierra Leone , at 40; Japan ranks first, with people living to an average of 83.

The panels also made the following recommendations:

Improve daily living conditions, including the circumstances in which people are born, grow, live, work, and age.

Tackle the inequitable distribution of power, money and resources - the structural drivers of those conditions - globally, nationally, and locally.